Development of a device for selective removal of CD4+ T cells

To control antigen (Ag)-specific immune cells is important in the treatment of autoimmune diseases. In particular, controlling the immune response of autoimmune T cells is effective in the treatment of these diseases. The development of a device that can remove CD4+ T cells specifically by extracorporeal circulation is now in progress, with the aim to deplete autoimmune T cells. We developed a removal material made of polypropylene non-woven fabrics with anti human CD4 monoclonal antibody immobilized on the surface. Using a column packed with the removal material, we succeeded in removing CD4+ T cells specifically from peripheral whole blood by direct perfusion. Moreover, CD4+ T cells can be specifically removed even from blood with lower surface antigen density by in vitro activation.     

Segmental resection of the third portion of the duodenum for a gastrointestinal stromal tumor: a case report

We describe a case in which segmental resection of the third portion of the duodenum was performed for a gastrointestinal stromal tumor (GIST). A 31-year-old woman was found to have a 3.5 cm hypovascular tumor at the posterior inferior aspect of the pancreatic head. Preoperative duodenal biopsy revealed that the tumor was positive for c-kit and vimentin, and was diagnosed as a duodenal GIST. Segmental resection of the third portion of the duodenum with papilloplasty and duodenojejunostomy was carried out and there were no postoperative complications. Pancreatoduodenectomy is not always necessary in the treatment of a duodenal GIST. This duodenectomy procedure can serve as a less extensive resection for a duodenal GIST located in the third portion of the duodenum.     

Controversy about treatment of colorectal cancer in view of surgeon--lymph node dissection for colorectal surgery (lateral lymph node dissection and TME)

Lateral lymph node dissection is technique for reducing local recurrence rate after resection of rectal cancer. In this study, we will report a decade experience for lateral lymph node dissection of rectal cancer in 491 cases. Lateral lymph node metastases occurred in 15.4% of rectal cancer which was below peritoneal reflection and through muscularis propria into non-peritoneal. It is a problem that it has never been well designed study of lateral lymph node dissection for rectal cancer. On the other hand, TME has also contributed reducing local recurrence rate. But, distant margin for resection of rectal cancer is controversial.     

Expression of matrix metalloproteinases in human transitional cell carcinoma of the urinary bladder

Matrix metalloproteinases (MMPs) are associated with invasion and metastasis of several human malignant tumors. Especially so MMP-7, as it is mainly produced by the actual cancer cells. However, the expression of MMP-7 in transitional cell carcinoma (TCC) of the urinary bladder has not been previously investigated. We examined expressions of MMP-7 and MMP-2 in TCC, and compared them with clinicopathological characteristics in TCCs. Tumor samples from 20 patients with TCC of the urinary bladder who had surgery performed at the Osaka City University Medical School Hospital were immunohistochemically stained. Expression of MMP-2 was significantly stronger in advanced stage and high grade tumors than in low stage and low grade tumors. MMP-7 was also expressed in TCC, having a tendency to be more strongly expressed in high than in low grade tumors. However, there was no significant difference of MMP-7 expression between advanced and low stages. This increased expression of MMP-7 in high grade TCC of the urinary bladder may be associated with tumor invasion and metastasis.     

CD29 and CD7 mediate galectin-3-induced type II T-cell apoptosis

Galectin (Gal)-3, a M(r) 31000 member of the beta-galactoside-binding protein family, is a multifunctional protein implicated in a variety of biological functions, including tumor cell adhesion, proliferation, differentiation, angiogenesis, apoptosis, cancer progression, and metastasis. Here, we report that secreted extracellular Gal-3 can signal apoptosis of human T leukemia cell lines, human peripheral blood mononuclear cells, and activated mouse T cells after binding to cell surface glycoconjugate receptors through carbohydrate-dependent interactions because the apoptotic effect was found to be inhibited by lactose, specific sugar inhibitor, and to be dose dependent. However, the apoptosis sensitivity to Gal-3 varied among the different cell lines tested. We report that Gal-3-null Jurkat, CEM, and MOLT-4 cells were significantly more sensitive to exogenous Gal-3 than SKW6.4 and H9 cells, which express Gal-3, suggesting a cross-talk between the antiapoptotic activity of intracellular Gal-3 and proapoptotic activity of extracellular Gal-3. Furthermore, Gal-3-transfected CEM cells were found to be more resistant to C(2)-ceramide-induced apoptosis than the control CEM cells. Identification of Gal-3 cell surface receptors revealed that Gal-3 binding to CD7 and CD29 (beta(1) integrin) induced apoptosis. Gal-3 binding to its cell surface receptors results in activation of mitochondrial apoptosis events including cytochrome c release and caspase-3 activation, but not caspase-8 activation. Taken together, these results suggest that the induction of T-cell apoptosis by secreted Gal-3 may play a role in the immune escape mechanism during tumor progression through the induction of apoptosis to cancer-infiltrating T cells. The induction of T-cell apoptosis by secreted Gal-3 is dependent in part on the presence or absence of cytoplasmic Gal-3, providing a new insight for the immune escape mechanism of cancer cells.     

The efficacy of hemodynamic and T-wave criteria for detecting intravascular injection of epinephrine test dose in propofol-anesthetized adults

A recent study demonstrated 100% effectiveness of hemodynamic criteria during propofol anesthesia, when a full dose of an epinephrine (15 microg)-containing test dose was injected intravascularly. We designed this dose-response study to determine minimal effective epinephrine doses and efficacies of hemodynamic and T-wave criteria for detecting intravascular injection of the epinephrine test dose in propofol-anesthetized adults. Eighty healthy adult patients were randomly assigned to one of four groups according to a simulated IV test dose using propofol (133 microg center dot kg(-1) center dot min(-1)) and nitrous oxide (FIO(2) = 0.33) anesthesia after endotracheal intubation (n = 20 each). The Saline group received 3 mL of normal saline IV; the Epinephrine-15 group received 3 mL of 1.5% lidocaine containing 15 microg epinephrine; and the Epinephrine-10 and -5 groups received 2 and 1 mL of the test dose of the identical components, respectively. Heart rate (HR), systolic blood pressure (SBP), and lead II of the electrocardiogram were recorded continuously for 5 min after the IV injection of the study drug via a peripheral vein. Sensitivities and specificities of 100% were obtained based on the modified HR (positive if greater-than-or-equal to 10 bpm increase) and the T-wave (positive if greater-than-or-equal 25% in amplitude) criteria if greater-than-or-equal 5 microg of epinephrine was injected IV. Based on the SBP criterion (positive if greater-than-or-equal 15 mm Hg increase), however, 100% sensitivity and specificity were associated only with greater-than-or-equal 10 microg of epinephrine doses. These results suggest that the minimal effective epinephrine doses for detecting unintentional intravascular injection are 5 microg based on the HR and T-wave criteria, and 10 microg based on the SBP criterion in adult patients anesthetized with propofol and nitrous oxide. IMPLICATIONS: Accidental migration of an epidural catheter into a blood vessel is often detected by hemodynamic changes after injecting an epidural test dose containing epinephrine. Our results suggest that 5 microg of epinephrine is not adequate to reliably produce hemodynamic and T-wave alterations in adult patients during propofol anesthesia.     

Development and evaluation of QA software for the monitor chamber of an accelerator

The monitor chamber of a radiotherapy system needs to be calibrated once a week. Because the calibration procedure requires a large variety of complicated calculations, we have developed software that facilitates calculation and enables comparison and storage of data. According to the standard measurement of absorbed dose, we used Visual Basic 6.0 (Microsoft Corp.) to establish the calibration method. This new technique has simplified the conventional intricate calculation required for calibration of the monitor chamber and enabled automatic processing of calculated results. We have confirmed the usefulness of this software in calibrating the monitor chamber. In the routine inspection, we can compare the current data with former results. Because of this advantage, it is possible to eliminate serious accidents such as overdosing and underdosing.     

Combination of stenting and coil embolization for carotid artery pseudoaneurysm causing symptomatic mass effect: case report

A case of cervical pseudoaneurysm secondary to carotid artery dissection causing symptomatic mass effect was reported. A 60-year-old woman presented with the complaint of right neck swelling and dysphagia that was considered to be the mass effect of a pseudoaneurysm caused by dissection of the right common carotid artery (CCA). Although a self-expanding stent was deployed to cover the orifice of the pseudoaneurysm, the pseudoaneurysm had been enlarged because of thrombus formation on the inner wall. A microcatheter was guided through the stent mesh into the aneurysm, and Guglielmi detachable coils were placed to embolize the orifice. One month later, angiography revealed complete embolization of the aneurysm while preserving flow in the CCA. The mass effect attributable to the pseudoaneurysm was relieved symptomatically as well as radiologically. Carotid artery dissection with symptomatic mass effect can be treated successfully, using a combination of stent and coils. This method may be considered to be an alternative to conventional surgical treatment such as proximal ligation, extracranial-intracranial bypass, or direct surgical repair.     

Stereotactic radiosurgery for aggressive papillary tumor of the temporal bone: case report

BACKGROUND: Papillary tumors of the temporal bone are very rare neoplasms that show locally aggressive behavior though they have low-grade histologic features. The best treatment for these tumors is a radical resection. However, if the tumor is very large, local invasiveness and hypervascularity can prevent surgeons from achieving a complete resection. As an additional treatment for the residual tumor, it remains controversial whether radiation therapy has any role. CASE DESCRIPTION: The authors describe a 53-year-old woman who suffered from left-sided tinnitus, hearing loss, and diplopia due to a large aggressive papillary tumor of the temporal bone. Radiosurgery was very effective for the tumor, which had regrown a few years after conventional radiation therapy and chemotherapy. CONCLUSIONS: The authors conclude that radiosurgery should be considered as an option for the treatment of aggressive papillary tumor of the temporal bone.